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RAS Mutations in Cutaneous Squamous-Cell Carcinomas in Patients Treated with BRAF Inhibitors

Open access
Su, Fei, Viros, Amaya, Milagre, Carla, Trunzer, Kerstin, Bollag, Gideon, Spleiss, Olivia, Reis-Filho, Jorge S., Kong, Xiangju, Koya, Richard C., Flaherty, Keith T., Chapman, Paul B., Kim, Min Jung, Hayward, Robert, Martin, Matthew, Yang, Hong, Wang, Qiongqing, Hilton, Holly, Hang, Julie S., Noe, Johannes, Lambros, Maryou, Geyer, Felipe, Dhomen, Nathalie, Niculescu-Duvaz, Ion, Zambon, Alfonso, Niculescu-Duvaz, Dan, Preece, Natasha, Robert, Lídia, Otte, Nicholas J., Mok, Stephen, Kee, Damien, Ma, Yan, Zhang, Chao, Habets, Gaston, Burton, Elizabeth A., Wong, Bernice, Nguyen, Hoa, Kockx, Mark, Andries, Luc, Lestini, Brian, Nolop, Keith B., Lee, Richard J., Joe, Andrew K., Troy, James L., Gonzalez, Rene, Hutson, Thomas E., Puzanov, Igor, Chmielowski, Bartosz, Springer, Caroline J., McArthur, Grant A., Sosman, Jeffrey A., Lo, Roger S., Ribas, Antoni, Marais, Richard·2012·New England Journal of Medicine

Abstract

BACKGROUND: Cutaneous squamous-cell carcinomas and keratoacanthomas are common findings in patients treated with BRAF inhibitors. METHODS: We performed a molecular analysis to identify oncogenic mutations (HRAS, KRAS, NRAS, CDKN2A, and TP53) in the lesions from patients treated with the BRAF inhibitor vemurafenib. An analysis of an independent validation set and functional studies with BRAF inhibitors in the presence of the prevalent RAS mutation was also performed. RESULTS: Among 21 tumor samples, 13 had RAS mutations (12 in HRAS). In a validation set of 14 samples, 8 had RAS mutations (4 in HRAS). Thus, 60% (21 of 35) of the specimens harbored RAS mutations, the most prevalent being HRAS Q61L. Increased proliferation of HRAS Q61L-mutant cell lines exposed to vemurafenib was associated with mitogen-activated protein kinase (MAPK)-pathway signaling and activation of ERK-mediated transcription. In a mouse model of HRAS Q61L-mediated skin carcinogenesis, the vemurafenib analogue PLX4720 was not an initiator or a promoter of carcinogenesis but accelerated growth of the lesions harboring HRAS mutations, and this growth was blocked by concomitant treatment with a MEK inhibitor. CONCLUSIONS: Mutations in RAS, particularly HRAS, are frequent in cutaneous squamous-cell carcinomas and keratoacanthomas that develop in patients treated with vemurafenib. The molecular mechanism is consistent with the paradoxical activation of MAPK signaling and leads to accelerated growth of these lesions. (Funded by Hoffmann-La Roche and others; ClinicalTrials.gov numbers, NCT00405587, NCT00949702, NCT01001299, and NCT01006980.).

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Metadata

Authors
Su, F., Viros, A., Milagre, C., Trunzer, K., Bollag, G., Spleiss, O., Reis-Filho, J. S., Kong, X., Koya, R. C., Flaherty, K. T., Chapman, P. B., Kim, M. J., Hayward, R., Martin, M., Yang, H., Wang, Q., Hilton, H., Hang, J. S., Noe, J., Lambros, M., Geyer, F., Dhomen, N., Niculescu-Duvaz, I., Zambon, A., Niculescu-Duvaz, D., Preece, N., Robert, L., Otte, N. J., Mok, S., Kee, D., Ma, Y., Zhang, C., Habets, G., Burton, E. A., Wong, B., Nguyen, H., Kockx, M., Andries, L., Lestini, B., Nolop, K. B., Lee, R. J., Joe, A. K., Troy, J. L., Gonzalez, R., Hutson, T. E., Puzanov, I., Chmielowski, B., Springer, C. J., McArthur, G. A., Sosman, J. A., Lo, R. S., Ribas, A., & Marais, R.
Venue
New England Journal of Medicine
Published
2012-01-19
Volume
366
Issue
3
Pages
207-215
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2155461614
Cited by
1,038
References
5
FWCI
58.20
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: RAS Mutations in Cutaneous Squamous-Cell Carcinomas in Patients Treated with BRAF Inhibitors. https://app.cochat.ai/papers/10.1056/nejmoa1105358
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Su, F., Viros, A., Milagre, C., Trunzer, K., Bollag, G., Spleiss, O., Reis-Filho, J. S., Kong, X., Koya, R. C., Flaherty, K. T., Chapman, P. B., Kim, M. J., Hayward, R., Martin, M., Yang, H., Wang, Q., Hilton, H., Hang, J. S., Noe, J., . . . Marais, R. (2012). RAS Mutations in Cutaneous Squamous-Cell Carcinomas in Patients Treated with BRAF Inhibitors. New England Journal of Medicine. https://doi.org/10.1056/nejmoa1105358

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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